HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED n
Date: Permit-Number:_
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)'462-1578
PERMIT APPLICATION FOR:
he.
Address: 20 ii:�A 4 ` o„ l' - M.
Property Tax ID#:
Site Plan Name: Lot No.
Project Name: Block No.
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If
MWA
New electrical Meter Second Electrical Meter
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V• .inw h " :��iezifirJ:: �g���2� i k.Additional work to be performed under this permit—check all that apply:
—Mechanical _Gas Tank —Gas Piping Shutters
-- _Windows/Doors, _Pond
—Electric —Plumbing —Sprinklers Generator
— _Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction:$_ J 2 g , 9
Utilities: —Sewer —Septic Building Height:
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Name
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Name:•
Address: �3D�/ jA���-0rc>1' Gy�y Com- an
P y:
City: State: / Address:
Zip Code:_ ,- '�J},S`/� Fax:
City: State:
Phone No.- 7 7 d_�/6�i-/ ��;
Zip Code: Fax: .
E-Mail:_ �P�?/4/ B(� �/. Cv� Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
from-the Owner listed above)
State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
YI
110M
"Not NApplic' ble MORTGAGE COMPANY: Not Applicable
DESIGNER/ENGINEER: — . .
Name: Name: ,
Address: Address: State:
State:
City: Zp'
Phone:
Zip: Phone
Applicable BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE HOLDER: Not App Name:
Name: Address:
Address: City:
City: Zip: Phone:
Zip: Phone:
OWNER/CONTRACTOR AFFICNIT:Application is hereby made. .a of ain'ermet it to do the work and installation.. indicated.
1'certify that no work or'installatiori has commenced Prior.to the issua P
St. Lucie County makes no reapresent eiNomeaOwnerstAsgociationirwill
esabylaws or the
dpcov nants that maydrestrictbor prohibit such
which is in conflict with any pp
structure.Please consult with your Home Owners'Association and review your deed for any restrictions which he workay
struct respects,perform" all res e ,
I will in P
do hereby agree
that ,
In consideration of the granting of this requested permit,I Y
in.accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
s are exempt from undergoing a full concurrency review:room additions,ential,use
buildin permit application P es to another non rest
following g P o us
fo s The g
accessory structures,swimming pools,fences,walls,signs,screen rooms accessory rY a in twrice for
WARNING TO.OWPIER:Your failure . -N ticeo Notice
f Commen ement must be commencement recorded.n the public records consult
Nofinancing,
e . A ain
Improvements to your prop rty.
Lucie County and posted o before commencingsite re the firs�tjnswork or recording If you
Notice of Commencement.
with lender or an alto
Signature wner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder .
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -
COUNTY OF
Sworn to(or affirmed)an sub cribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization
'
Physical Presence or On e Notarization this day of J 20— by
this day o 20_ by
Name of person making statement.
h�.��IhAn
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification Type of Identification. J
Type of Identifi atio Produced
Produced
(Signature of Notary Public-State of Florida)
Signature of N KAREN S. NI LSE "V
,PY (Seal)
moo`' State of Florida]j �(y Public Commission No.
Commission No =_ ission # �L07484
my Commission Expires
June 12 2022
PLANS VEGETATION S EATURTLE MANGROVE
REVIE
WS FRONT ZONING SUPERVISOR REVIEW REVIEW REVIEW
REVIEW REVIEW
COUNTER REVIEW
DATE
C-FINED
RECEIVED
DATE SEP 10 2020
COMPLETED
ev• Department
Permitting P
St.Lucie County